The page could not be loaded. The CMS.gov Web site currently does not fully support browsers with
“JavaScript” disabled. Please enable “JavaScript” and revisit this page or proceed with browsing CMS.gov with
“JavaScript” disabled.
Instructions for enabling “JavaScript” can be found here.
Please note that if you choose
to continue without enabling “JavaScript” certain functionalities on this website may not be available.

MLN Provider Compliance

Fast Fact

In order for an enteral nutrition pump to be covered, sufficient evidence must be provided to support determination of the medical necessity for the pump. Program payment for the pump is based on the reasonable charge for the simplest model that meets the medical needs of the patient as established by medical documentation. Please refer to Provider Compliance Tips for Enteral Nutrition Pumps for more information.

The Medicare Learning Network® (MLN) Provider Compliance page contains educational products that inform health care professionals on how to avoid common billing errors and other improper activities when dealing with various CMS Programs. CMS’ claim review program’s overall goal is to reduce improper payment error by identifying and addressing coverage and coding billing errors. Since 1996, CMS has implemented several initiatives: to prevent improper payments before a claim is processed; and to identify, and recoup improper payments after the claim is processed.

The Downloads section contains MLN products, MLN Matters® Articles, and the “Archive of Medicare Quarterly Provider Compliance Newsletters” which have been designed to provide education on common billing errors and other improper activities. These lists, as well as other information in the Downloads and Related Links section, are updated as new products and articles are developed and existing products and articles are revised.